Probable pulmonary embolism with repeat administration of prothrombin complex concentrate in a factor Xa inhibitor patient

Abstract

Treatment of DOAC-induced bleeding remains an "off-label" indication for PCC. Additional doses should be given with caution if given at all and patients monitored closely.

Use of Prothrombin Complex Concentrate in Oral Anticoagulant-Associated Major Bleeding

“…In addition to the lack of clinical benefit, repeat dosing may lead to excessive accumulation of factors and cause a prothrombotic state. Case studies have shown probable thromboembolic complications caused by repeat dosing, especially at doses greater than listed in the package insert 30,31. Finally, repeat dosing is not recommended in the package labeling due to lack of available safety information; however, repeat dosing has been shown to be common in practice and should be evaluated on a case-by-case basis 32…”